Bourne, Chanell Raven

Bourne, Chanell Raven is an individual health care provider with primary practice located at 593 Eddy St , Providence RI 02903-4923. She recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as her primary health care specialty. Bourne, Chanell Raven can be contacted via phone (401) 444-5180.

Contact Information

Primary practice address
593 Eddy St Providence RI 02903-4923
Phone: (401) 444-5180
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X LP05536 Rhode Island

Profile Details

NPI number 1356089775
LBN Legal business name Bourne, Chanell Raven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2022
Last updated May 25th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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